Active NPI
Kathleen Jacqueline Magner, DO
- Family Medicine Physician
- Ballston Spa, NY
National Provider Identifier
1255918355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 331819
- Practice address
- 510 Geyser Rd
Ballston Spa, NY 12020-3007 - Phone
- (518) 289-2720
- NPI assigned
- Mar 25, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 331819 | NY | Primary |
Addresses
Primary practice location
510 Geyser Rd
Ballston Spa, NY 12020-3007
Mailing address
205A Van Aernem Rd
Ballston Spa, NY 12020-3803
Phone (201) 230-1877
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 331819 | Other | NY | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Rowan University School of Osteopathic Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
510 Geyser Rd
Ballston Spa, NY 12020-3007
Phone (518) 289-2720
Hospital & facility affiliations
- Saratoga Hospital
- Albany Medical Center Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 331819 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saratoga Hospital | Current | Accepting new patients | |
| Saratoga Hospital | Family Medicine | Current | Accepting new patients |
| Saratoga Hospital | Current | Accepting new patients |
Locations
510 Geyser Rd
Ballston Spa, NY 12020
Phone (518) 289-2720
112 Charlton Rd
Charlton, NY 12019
Phone (518) 399-7723
1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705
Interoperability endpoints
- kmagner19363@albanymed.direct-ci.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1073569331
-
- Community/Retail Pharmacy
- Saratoga Springs, NY
- NPI 1164148110
Hospital & facility affiliations 23
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Ambulatory Surgical Clinic/Center
- Niskayana, NY
- NPI 1154973071
Hospital
-
- General Acute Care Hospital
- Albany, NY
- NPI 1376577247
-
- General Acute Care Hospital
- Albany, NY
- NPI 1811917461
-
- Endocrinology, Diabetes & Metabolism Physician
- Gansevoort, NY
- NPI 1033371166
Hospital
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1073569331
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1093078560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1255918355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205A VAN AERNEM RD",
"city": "BALLSTON SPA",
"state": "NY",
"postal_code": "120203803",
"telephone_number": "201-230-1877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 GEYSER RD",
"city": "BALLSTON SPA",
"state": "NY",
"postal_code": "120203007",
"telephone_number": "518-289-2720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGNER",
"first_name": "KATHLEEN",
"middle_name": "JACQUELINE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-25",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "331819",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "331819",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ballston Spa, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.